The osteoarthritis of the knee joint combines two processes: destruction of cartilage and the growth of osteophytes or bone spurs.The process stage is determined by radiography.Rooming osteoarthritis is the destruction of the knee joints with age, the natural process of aging.The causes are a weakening of the muscles and a bad blood supply to the tissues.How to get treatment without surgery?Eliminate the factors that have reduced muscle tone.
Causes
The causes of osteoarthritis are still not determined by medicine,Only risk factors are named:Age of over 45, knee injuries and overweight.Almost 50% of the adult population has never complained about the knee joint.
With osteoarthritis, cartilage lining the edges of the bones is abrasion or completely absent.The damaged tissue is not a source of pain because it has no receptors.Inflammation in neighboring structures causes characteristic symptoms.
The body continues the regeneration of damaged tissues, but cartilage is developing unevenly.Consequently, irregularities are formed which hurt other elements of the joint.The nature of the osteophytes is explained by compensation for cartilage smooth articulation.Another version indicates that the growth of "spurs"It is associated with an attempt to stabilize the medial or lateral joint due to muscle weakening.
What is the chronic osteoarthritis of the knee joint?Pain occurs in tendons and ligaments when muscle forces stop holding the bones and controlling them.Therefore, biomechanical causes of pain and osteoarthritis are distinguished:
- In the context of a long seatThere is a compression between the inguinal ligament and the iliac folding muscle of the femoral artery and the nerve, which weakens the force of the front of the thigh and leads to the appearance of the tension in the tendon-sous the knee.
- Long -term seated the gluteal musclesWeaken them.Instead, the pear -shaped muscles begin to work, under which the sciatic nerve passes.During its compression, the double -headed muscle weakens, the angle of the thigh and the low leg changes.The knee is injured.
- Heel walkingIt causes the tension of the muscles of the calf, deploys the basin, weakens the medium frination muscles.The femoral bone turns inside, the ligaments are loaded along the interior of the knee, a medial meniscus, the osteophytes develop.
- Flat feetAssociated with the wearing of uncomfortable shoes, a weakening of the main muscles and with increased lordosis, exceeds the tibial bone outwards, which causes knee pain due to the violation of biomechanics, the development of the cyst of a baker.
The pathological chains affecting the knee are associated with a fall on coccyx in childhood, scoliosis caused by internal organ disease.People who have a different shoulder height,Over time, they are starting to complain about the knee, since the fascial chains at the front of the body include the extensor of this joint - the rectus muscle of the thigh.
Symptoms
The degenerative process disrupts the function of the joint, causes pain and stiffness.We think it'sCartilage and bone, the effect on muscles begins.The practice shows the opposite -Pain in knee joint occurs in tendon places- Finage of weakened muscles of extensors, flexors and knee stabilizers.
The main signs of the threat of cartilage wear and tear:
- From time to time, the discomfort associated with walking, the feeling of "not thus adjusted the leg".
- The appearance of pain with a direct load on the joint and muscles, flexion and extension - squat, mount the stairs.
- Pain in the knee and stiffness after an extension of inaction or rest, for example, when leaving the bed in the morning, which is associated with the stagnation of venous blood.
The main signs of osteoarthritis are caused by the load on the weakened muscles:
- The knees in the knees are linked to the fact that the gluteal and double -headed muscle which extends the thigh does not work and that the muscle of the rectus thigh is excessively stretched, creating discomfort in the knee.
- The pain when flexing the joint is associated with the weakness of the flexors - the double -headed muscle and the tension of the quadriceps tendon.
The swelling is caused by injuries to soft tissue, inflammation of the tendons and the joint bag.The appearance of heat in the knee, swelling indicates the accumulation of inflammatory exudat -Arthrosis is often accompanied by bursitis, synovitis, tendinitis.
The crunch in the knee is painless and traumatic.Clinkles and other sounds do not say that bones are abrasion.Signs of violation of knee stability -The weakness of one of the muscle controls.
Cruting caused by bone bone friction does not occur at the beginning and at the end of the amplitude of movement, but in the middle,Even with a passive flexion of the joint.The joint blocking is caused by the wear and tear of the cartilage and tendons, which creates a feeling of fixing.The bones with any movement are controlled by muscles.Their premature reduction leads to a changed direction of the bone movement, blocking.
1 degree
The determination of the degree of osteoarthritis occurs by the X -scratchrevealing participation in the pathological process of bone structures.Their change indicates that the muscular system has been in an imbalance for 5 to 10 years.As a rule, peopleFor several years, they experience painful pain.
At the first stage of osteoarthritis, which is detected by accident, a slight increase in bone spurs occurs.The growth appears in the places of the greatest instability of the joint.As a rule, patients rarely experience pain or discomfort during movement.
The weakness of certain muscles is compensated by the function of others, without causing spasms and serious overloads.Race and training with weights cause symptoms because the weakened muscles are loaded.The weakness (hypotension) of the muscles is associated with alteration in blood supply and innervation.
2 degrees
The second stage of osteoarthritis is considered easy.X -ray reveals significant bone spurs, but cartilage is not affected.The amount of synovial fluid is reduced, but the symptoms of pain appear after a long step and a race, stiffness in the joint and pain during flexion and in the position on the knees.
The first characteristics of X -rays of the second stage of knee osteoarthritis:
- The pointed edges of interminement tubers on the tibia, where the cross -shaped ligament is attached;
- narrowing of the joint gap on the medial side;
- The pointed edges of the condyles of the bones on the medial sides, less often in lateral - depending on the development of the valgus or the varial articular deformation.
For the second stage of LarsenThe narrowing of the joint deviation of more than 50% is characteristic, but this can only be verified in dynamics or comparison with a different seal.
3 degrees
At the third stage of osteoarthritisPain during the bending and extension of the joint become constant.During exacerbation, the joint blushes and swells, the painful pains do not stop at rest.Around the knee, swelling appears, a notable deformation of the joint joints.
Signs of moderate osteoarthritis of the knee joint in the third stage:
- The joint space is considerably reduced;
- the presence of subchondral sclerosis in the busy sections;
- many osteophytes on the edges;
- a rare appearance of subchondral cysts;
- Synovites, the appearance of a cyst of a baker under the knee;
- unequal surfaces of femoral and tibia, the loss of joint joints;
- change in the form of the ball joint;
- Calcification and chondrophy foci;
Rarely the fourth step is supplemented by necrotic lesions.Why is osteoarthritis dangerous?The disease violates the ability to move, creates dependence on others.
Diagnosis
The orthopedist studies the signs of edema, palpte the joint of pain, studies the active and passive range of movement.Necessarily inspect the lumbar column, becauseThis is where the nerves pass, which provide the function of the thigh muscles.
The radiography shows the presence of osteophytes, a change in space between femoral bones and tibia, which indicates the loss of cartilage in the knee.Sometimes the X -ray of the knee joints shows significant signs of cartilage wear, but patients do not feel significant pain.On the contrary, osteoarthritis of the first step can disturb the knee function, since the cause of pain is the hypotonic muscles.
If an X -rating does not show big changes, thenThe doctor prescribes an MRI of the knee and lumbar joint.The diagnosis visualizes ligaments, tendons and muscles, the meniscus to find other sources of pain.
Laboratory diagnosis is necessaryIf you suspect infectious damage to joint or drop.
Treatment
Osteoarthritis therapy should be completeintended for the cause of the disease.With endocrine dysfunctions capable of affecting connective tissues, appropriate treatment is carried out.Overweight patients are recommendedgo to good nutrition.Exacerbations are removed with medication.
Drugs
The drug treatment of pain consists inprescription of anti-inflammatory drugs.Non-steroidal anti-inflammatory drugs with prolonged useNegatively affect the stomach function.
The treatment regime includes chondroprotectors, which only help when they take courses during3-6 months.Pharmacies represent a large number of drugs in this group.
It is believed that the components of these drugs help to regenerate the structure of cartilage, have an analgesic effect.
Controlled studies have been carried out shortly, and they concerned a complex treatment - arthroplasty, physiotherapy, food.
Attention!Chondroprotectors are drunk in courses - you can drink a course in a medication and the second course - the other, and compare the effect.However, uncontrolled drug is not the best idea.Before you start taking medication, see your doctor.
How and what to relieve pain and swelling?Intra-articular injections are more popular:
- SteroidInhibit inflammatory reactions in immune cells, eliminating acute pain, joint joints and swelling.
- Hyaluronic acidIncreases the viscosity of the joint fluid, reducing the friction of the joint surfaces.
Important!The effect of drugs is sufficient for 6 to 12 months, but at the same time, degenerative processes do not stop.
Surgical treatment
With low drug effectiveness, patients are offered arthroscopy- A mini-invasive procedure for the elimination of bone growth, the audit of the joint.If necessary, the surgeons carry out ligaments and cartilage plastic, remove the fireplace from the worn tissue.
Bone osteotomy aims to change the axis of the load on the joint.The doctor cuts the femoral or berets to change the contact areas of joint surfaces.The operation is often carried out in young patients.
Total replacement of knee or arthroplasty jointIt is necessary at the grave stage of osteoarthritis (third or fourth degree).Surgical treatment does not always solve the problem because it requires a diligent and daily rehabilitation, the strengthening of the muscles.
Changes in the knee can be compensatory compared to the basin, therefore, without restoration of muscle balance, the hip joint then suffers.
Physiotherapeutic treatment
In the environment of physiotherapy, mud applications, phonophoresis and magnetic therapy are used.The action of external factors aimsStimulation of blood supply and tissue regeneration, relief of inflammation and swelling.
Treatment with popular and non -traditional methods
Recipes for folk remedies for the treatment of osteoarthritis of the knee joints at home generallyaimed at eliminating swelling and elimination of pain.Most often, horseradish leaves and potato porridge are used, sometimes the mixture and vodka for the compresses are mixed.
It is impossible to completely stop degeneration.You can affect the exchange in the kidneys using celery juice.The kidneys are associated with the Iliac-Luxury muscle, which is associated with the pathologies of the hip joint.The normalization of the function of the gallbladder and the liver improves the condition of the knees.
The methods of treatment of the initial stage of the initial stage of osteoarthritis of the knee include decoctions of anti-inflammatory herbs:Chamomile, must of Saint-Jean, immortality.Molus waste, sea salt and kerosene are used.Baths with magnesium salts, pine infusions are used.
Manual therapy and massage
Manual therapy for osteoarthrosis of knee joint helps, if a specialist includes muscle imbalances alone.Muscle tests help find weakened muscles that stabilize the knee, determine the cause of dysfunction and eliminate it.
The source cannot only be the joint block in the lumbar region,but also dysfunctions in terms of blood supply, internal organs, endocrine and biochemical failures.Consequently, the manual therapist must have osteopathy skills, applied kinesiology in order to influence many factors.
Massage is an auxiliary tool for manual therapy, Auto-Help.A patient with osteoarthritis of the knee joint can independently knead the tendons of the muscles which control the movement of the member:
- the area around the large gluteal muscle;
- lines on the front surface of the thigh - from the patella basin;
- The lateral surface of the thigh of the large swing with the condyles of the thigh;
- The groin area along the inguinal ligament;
- The interior surface of the thigh (along the main channel line).
The massage is executed, without much pressing.
Therapeutic gymnastics
The cause of osteoarthritis is the weakening of the muscles caused by problems in the lower back, the pelvis, the abdominal cavity.Perform exercises for the prevention of arthritis and osteoarthritis of the knee joints for the elderlyIt is possible to increase strength, but not the tone.
Without working on the factors of their weakening using manual therapy, it is difficult to carry out a complete restoration of the biomechanics.Yoga still deprives the joints of stability.Among treatment methods, it is better to preferPilates and Scandinavian walking.
Diet
The food is adjusted, first of all, to fight overweight.It is important to abandon sugar and simple carbohydrates, add products with fibers, magnesium, group B vitamins and calcium with osteoarthritis of the knee joint, which are important for muscle activity.To tryExclude dairy products, since almost 80% of the population has lactose intolerance.
Prevention of osteoarthritis of the knee joints
Attempts to strengthen muscles do not always help, because the innervation and the blood supply are not restored.The function of hip muscles depends on the lumbar plexus.
Changes in the lower back associated with the weakness of the abdominal muscles also affect the knees.Consequently, in men with a "beer belly", osteoarthritis is more common, as in women after a multi -Garden goalkeeper, several genres with diastase - a weakening of the muscles of the abdominal wall.
The operations in the basin and the internal organs form adhesions that affect the vertebrae of the lumbar region, violating the innervation of the muscles around the knee.
Which doctor contact with osteoarthritis of the knee joint?Diagnosis will help make an orthopedicwho will insist on the operation.The best results are given by the work of multidisciplinary teams in rehabilitation centers.
The best that can be done for joints:Eat well, watch the weight, walk more, visit a massage therapist or an osteopath once every three months.
Treatment Opinion
Positive journals can only provide a complete treatment of distorting osteoarthritis of the knee joint or gonarthrosis.Anesthesia, intra-articular injections act temporarily, eliminating a natural inflammatory reaction.
Conclusion
The problem of osteoarthritis is that the drug treatment temporarily eliminates only pain syndromes.The reasons are left without identification or influence.Occupational therapists who learn to live with osteoarthritis of the knee joint can come to help and how to properly use a cane.But the service is only available in private clinics that make rehabilitation.